Pulse article: survey of neurogenic bladder management in spinal cord injury patients around the world

Spinal Cord Series and Cases, 2021 · DOI: 10.1038/s41394-021-00388-4 · Published: February 10, 2021

Simple Explanation

Neurogenic bladder (NGB) is a condition where the lower urinary tract doesn't function properly due to damage to the central or peripheral nervous system, often seen in patients with spinal cord injury (SCI). Common symptoms include urinary urgency, frequency, hesitancy, intermittency, incomplete bladder emptying, and incontinence. This international survey was conducted to identify variations in neurogenic bladder management around the world, aiming to understand global and cultural differences. The survey asked healthcare professionals about demographics, access to specialized care, management methods, diagnostic approaches, and common complications. The survey results revealed that management decisions, especially catheterization methods, vary significantly worldwide. These discrepancies may be due to a lack of awareness and adherence to current local neurogenic bladder management guidelines, as well as the absence of unified global guidelines.

Study Duration

6 weeks

Participants

296 healthcare professionals

Evidence Level

Not specified

Key Findings

1
Global concurrence was noted among management method for patients without adequate hand function, ﬁrst-line treatment for neurogenic detrusor overactivity, and common complications.
2
Continents highly differed in responses regarding management method for patients with adequate hand function, frequency of patients reusing catheters, timing of urodynamics, and duration of antibiotic therapy for urinary tract infections.
3
For patients with adequate hand dexterity in acute care, indwelling catheter was much more common in Africa, Asia, and Australia than in North and South America, where clean intermittent catheterization was preferred.

Research Summary

This study highlights the variations in neurogenic bladder management for SCI patients across different continents. The survey results indicate significant differences in catheterization methods, reuse practices, and diagnostic approaches. Factors such as access to specialized care, economic development, governmental regulations, cultural beliefs, and adherence to guidelines contribute to these discrepancies. Increased access to care and dissemination of management guidelines may help reduce the disparities. The authors suggest that increased international educational events and provider education can improve transparency and communication, ultimately reducing discrepancies in care and paving the way for possible consensus and guidelines in NLUTD SCI care.

Practical Implications

Standardized Guidelines

Develop and disseminate globally unified guidelines for neurogenic bladder management to reduce discrepancies in care.

Increased Education

Promote international educational events and provider education to improve transparency and communication among healthcare professionals.

Improved Access

Enhance access to specialized care for neurogenic bladder dysfunction, especially in developing countries, to ensure consistent management practices.

Study Limitations

1
Limited data from certain continents (e.g., South America and Africa) due to a smaller number of respondents.
2
Lack of data from Middle Eastern regions.
3
Variations in sample sizes for each survey question due to incomplete responses from participants.

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